ConnectiCare Standard Dental Plan - 94815CT0070001 Health Insurance Plan
ConnectiCare Insurance Company Inc. health insurance plan with the Plan ID 94815CT0070001. The plan is called ConnectiCare Standard Dental Plan.
| Health Insurance Plan ID | 94815CT0070001 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | Connecticut | ||||||||||||||||||
| Health Insurance Issuer | ConnectiCare Insurance Company Inc. | ||||||||||||||||||
| Health Insurance Plan Variant | 94815CT0070001-01 | ||||||||||||||||||
| Provider Network(s) | ['CTN001'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 07 May 2024 06:08 GMT). |
|
||||||||||||||||||
| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Mon, 23 Jan 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
ConnectiCare Standard Dental Plan Health Insurance Plan Variant 94815CT0070001-01 Attributes
| Plan Attribute | Value |
|---|---|
| Business Year | 2023 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard High On Exchange Plan |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 100% |
| First Tier Utilization | 100% |
| HIOS Product ID | 94815CT007 |
| Import Date | 1/23/2023 |
| Guaranteed Rate | Guaranteed Rate |
| IsItANewPlan | New |
| Issuer ID | 94815 |
| Market Coverage | Individual |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family | per person not applicable | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out | Not Applicable |
| Medical EHB Deductible, Combined In/Out of Network, Family | per person not applicable | per group not applicable |
| Medical EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
| Medical EHB Deductible, In Network (Tier 1), Family | $60 per person | $180 per group |
| Medical EHB Deductible, In Network (Tier 1), Individual | $60 |
| Medical EHB Deductible, Out of Network, Family | $60 per person | $180 per group |
| Medical EHB Deductible, Out of Network, Individual | $60 |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family | $350 per person | $700 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $350 |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family | per person not applicable | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual | Not Applicable |
| Metal Level | High |
| Multiple In Network Tiers | No |
| National Network | No |
| Network ID | CTN001 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | No |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 94815CT0070001-01 |
| Plan Marketing Name | ConnectiCare Standard Dental Plan |
| Plan Type | PPO |
| Plan Variant Marketing Name | ConnectiCare Standard Dental Plan |
| QHP/Non QHP | On the Exchange |
| Service Area ID | CTS001 |
| Source Name | SERFF |
| Plan ID | 94815CT0070001 |
| State Code | CT |
| Version Number | 1 |
| Wellness Program Offered | No |
Copay & Coinsurance of ConnectiCare Standard Dental Plan Health Insurance Plan, 94815CT0070001
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about ConnectiCare Standard Dental Plan, 94815CT0070001 Health Insurance Plan, 94815CT0070001
-
Does ConnectiCare Standard Dental Plan Health Insurance Plan, 94815CT0070001 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (94815CT0070001) Health Insurance Plan, Variant (94815CT0070001-01) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (94815CT0070001) Health Insurance Plan, Variant (94815CT0070001-01) have Out of Service Area Coverage?
No, unfortunately there
is no Out of Service Area Coverage for this Health Insurance
Plan (variant of plan).
Disclaimer: This is based on the import(Date: Tue, 07 May 2024 06:08 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API